ProstRcision vs Brachy + IMRT?

Prostrcison is permanent seed brachytherapy and adjuvant IMRT. It is the trade name that Dr. Frank Critz uses to describe the treatment method he pioneered. His version uses the two together rather than sequentially. Thus, while the seeds are at their strongest he applies the IMRT to get a multiplying effect.

I know the system and RCOG (owned by Northside Hospital) very well. I consulted with them and my wife had a very delicate radiation treatment for breast cancer by one of their radiation oncologists. Very high caliber group and they have treated thousands of men with Prostrcision method.

I chose a similar method that uses High Dose Rate brachytherapy amd adjuvant IMRT. I chose the HDRBT over the permanent seeds for a number of reasons including a higher and quicker radiation dose that is more effective with PCa, the radiation was not left inside so there could be no seed migration, the better use of CT scans to more precisely place the radiation, etc. All of this is to improve cancer control and minimize the side effects. But, had the HDRBT not been available I would have used RCOG and the Prostrcision method. This would be convenient for me as I live in the Atlanta area. But, I also had two high caliber HDRBT radiation oncology centers available in Atlanta so I chose the HDRBT method.

Where are you located? There are several fine HDRBT practitioners in several different cities. There are more permanent seed centers as it requires less expensive technology to deliver.

Like JNF, I'm another HDR brachy + IMRT guy. Certainly worked well for me, but if I'm reading your signature line correctly, you're in the favorable intermediate risk group. To that end, brachytherapy would generally be used by itself. Or, to flip that around, IMRT (or SBRT) would be used by itself.

Keep in mind that IMRT is a multi-week procedure if you're having that done away from your home. SBRT is a much briefer treatment.

That approach is understandable. Just keep in mind that no treatment is a free pass and you do increase the odds of SEs as you layer things on so that's something to balance against your caution. Glad you're doing your due diligence on your options!

If you haven't seen it already, Dr Demanes at UCLA (one of the top HDR docs in the country) has some info on monotherapy vs combo treatment at this website: http://www.cetmc.com/prostate.html

Allen,

Thanks for the enlightening article on brachy-boost. In the week since my BX results I've learned a tremendous amount.

Dr Gearhead